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Best Practices in Insurance Licensing Forum
Best Practices in Insurance Licensing Forum Agenda • 10:00 – 10:30 Welcome and Opening Comments Sonya Dungey, Director of Licensing Michele Riddering, Licensing Manager • 10:30 – 10:50 Consumer Services Division Kristie Taber, Manager – Communications Center and Consumer Assistance Regan Johnson, Manager – Market Conduct • 10:50 – 11:00 Legislative Update Jenita Moore, Deputy Commissioner – Policy • 11:00 – 12:00 Producer Licensing Guiding Principles Deborah Canja, Deputy General Counsel – Office of General Counsel • 12:00 – 1:00 Lunch • 1:00 – 1:30 DOB Conversion: Continuing Education Tracy Lord Bishop, Education Administrator • 1:30 – 2:30 Business Entity Licensing Jennifer Childs, Licensing Analyst SueEllen Tyszkiewicz, Licensing Analyst • 2:30 – 3:00 Technology Update Terri Mann, Technology Specialist • 3:00 – 3:15 Break • 3:15 – 4:30 Entry Level Licensing Exams Paige Colley, Testing Specialist Tadas Dabsys, Vice President – PSI Services Nikki Shepherd Eatchel, Vice President – Prometric Dr. James Fryer, Senior Sales Executive – Pearson VUE Craig Johnson, Client Services Manager – Prometric • 4:30 – 4:45 Problem Applications Tracey Peck, Producer Licensing Specialist • 4:45 –5:00 Questions & Answers Adjournment NEXT Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Pre-Licensing Education Background Checks Licensure Application Continuing Education Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Commercial Lines Commissions Surplus Lines Limited Lines Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Pre-Licensing Education Background Checks Hours Required Licensure Application Restore Continuing Education Waiver / Exemption Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Pre-Licensing Education Background Checks Licensure Application State-wide Criminal History Continuing Education Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Pre-Licensing Education Background Checks Licensure Application Continuing Education 6 Major LOA’s Core Limited Lines Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Pre-Licensing Education Background Checks Licensure Application Continuing Education Term of Compliance Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Commercial Lines Commissions Multiple Exemptions Surplus Lines Limited Lines Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Commercial Lines Commissions Surplus Lines Commission Sharing Limited Lines Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Commercial Lines Commissions Surplus Lines Limited Lines Surplus Lines Exam Restore Review of NAIC Compliance Since 2007, OFIR has increased uniformity with NAIC by…. Commercial Lines Commissions Surplus Lines Limited Lines CE Requirement – Resident Producers Restore Licensing Population Active Resident Licensees as of December 31, 2009 Individual Producer Individual Producer – Surplus Lines Business Entity Producer 55,594 332 8,325 Business Entity Producer – Surplus Lines 138 Adjuster for the Insured 123 Insurance Adjuster Counselor 1,762 931 Solicitor 1,453 Resident License Total: 68,658 Licensing Population Active Non-Resident Licensees as of December 31, 2009 Individual Producer 119,430 Individual Producer – Surplus Lines 1,074 Business Entity Producer 8,100 Business Entity Producer – Surplus Lines Adjuster for the Insured Insurance Adjuster Counselor 346 87 5,645 37 Non-Resident License Total: 134,719 Michigan Total Insurance Population: 203,377 Insurance Licensing Bulletins •Bulletin 2010-06-INS: Approval of New Contract Form for Adjuster for the Insured Residential Contracts •Bulletin 2010-05-INS: Insurance Crop Adjuster Licensing •Bulletin 2010-01-INS: Designated Responsible Licensed Producer Affiliations •Bulletin 2009-15-INS: Insurance Producer Variable Life/Variable Annuities Line of Authority (supersedes Bulletin 1990-04) Consumer Services Division Kristie Taber, Manager Communications Center and Consumer Assistance Regan Johnson, Manager Market Conduct Consumer Assistance Section • Assists consumers with insurance and financial services problems and questions • OFIR received approximately 5,618 consumer complaints last year: 3,051 Insurance 1,042 Blue Cross & HMO 1,030 Consumer Finance 165 Securities 330 Credit Unions/Banks • Total recoveries over $16 million Our Goals Educate the consumer Make sure the consumer is treated fairly and within standard business practices Ensure compliance with statutes Complaint Statistics by Reason & Coverage • • • • • Claim Handling 46% Customer Service 26% Underwriting 9% Marketing and Sales 8% Non-compliance 11% • • • • • • • Accident & Health 50% Homeowners 12% Auto 20% Life 9% Annuity 5% Liability 2% Fire & Commercial 2% Common Insurance Complaint Issues • • • • • Misrepresentation/Unsuitability in the Sale of Equity Indexed or Variable Annuities and Universal Life Policies Rating Complaints: - Long Term Care Rate Increases - Affordability of auto and home insurance - Availability and affordability of health insurance Medicare Supplement Duplication of Coverage Fiduciary Violations Claim Issues – Health Insurance Claim Denials – Automobile – Personal Injury Protection – Homeowner Business-To-Business Complaints • Business-to-Business complaints handled by Investigations Section • OFIR will not intervene in contractual disputes : - Do not review questions regarding payment of commissions, etc. • If dispute involves alleged violation of Insurance Code, may review with supporting documentation Complaint Process 1. Complaint arrives – must be submitted in writing 2. Assigned to analyst by topic 3. Forwarded to insurer and/or agent for response - Response due in 21 calendar days - Fine imposed for failure to respond - Company cannot respond on behalf of agent - Must respond in duplicate 4. Analyst reviews response and documentation submitted by licensee and consumer Complaint Process 5. Complaint analysts are impartial in their review - Documentation submitted is crucial to their determination on file 6. OFIR will determine - Is consumer harmed by activity? - Is activity in violation of Insurance Code? 7. Analyst makes file determination: - Request additional information - Close complaint; closing letter sent to consumer - Refer to Investigations for review and action Common Violations & Referrals • • • • • • • • • Unlicensed Activity/Fraud Fiduciary issues; premiums not remitted, misappropriation/embezzlement of funds Binding coverage without appointment with insurer Public Adjuster – Charging fees in excess of 10% allowed – Advancing money to insured – Not maintaining required records – Soliciting insured at the scene of the fire – Requiring their name on all settlement checks to the insured Agent forgery Agent misrepresentation of insurance policy False and/or misleading advertising False statements relative to an application for insurance Rebating What We Can & Cannot Do • Investigate complaints against persons and business entities accused of violating Insurance Code • Interpret statute • Bring administrative actions or refer to Attorney General for civil or criminal prosecution • Act as court of law • Act as an attorney or give legal advice • Take action in matters involving internal affairs of a business Summary Purpose of Consumer Assistance is to: Ensure consumers are treated fairly and in accordance with the law Detect violations of law and take appropriate action Legislative Update Jenita Moore, Deputy Commissioner Policy Division Producer Licensing Guiding Principles Deborah Canja, Deputy General Counsel Office of General Counsel The Internet: Popular Sites for Locating People • • Fee Based Databases irbsearch.com merlindata.com locateplus.com tracers.com flatrateinfo.com pallorium.com skipsmasher.com Directory Assistance masterfiles.com argali.com • Free Databases google.com zabasearch.com peoplefinder.com yahoo.com altavista.com myfamily.com birthdatabase.com zoominfo.com The Internet (cont.) • • Registered WWW Domain networksolutions.com Blog Searching blogsearch.google.com technorati.com daypop.com journalspace.com blogdigger.com easyrss.com feedster.com blog.com • Directory of Public Records searchsystems.net publicrecordcenter.com • Business Searches goliath.ecnext.com manta.com guidestar.org • Additional Avenues lexisnexis.com nexis.com accurint.com The Internet: Michigan Courts/Services Online • Michigan v. Florida v. California online culture • Years computers search • Offender Tracking Information System (OTIS) • Michigan State Police ICHAT Service co.genesee.mi.us oakgov.com/courts macombcountymi.gov courts.ingham.org ($11) 55th District, Mason 67th District, Flint 61st District, Grand Rapids 89th District, Cheboygan Lunch Main Concourse Upper Level DOB Conversion: Continuing Education Education Administrator Tracy Lord Bishop Continuing Education Review Date Previous method used a combination of: Previous Method New Method Example A The Last # of Social Security Number Example B Example C Example D First letter of last name Continuing Education Review Date The new method uses a combination of: Previous Method New Method Birth Year Birth Month Example A Example B Example C Even Odd Birth Year Example D Last completed CE review date: • 2008 – new review date in 2010 2011 • 2009 – new review date in 2012 2011 Review Date: •First day of of birth •First day birth month, month, 2012 2011 •Repeat •Repeat every every 2 2 years years Continuing Education Review Date Previous Method New Method John Doe Example A Date of Birth: January 26, 1980 & last CE date 6/1/09 Example A Example B Example C Example D CE Review Dates • Jan. 1, 2012 • Jan.1, 2014 Continuing Education Review Date Previous Method New Method Jane Doe Example B Date of Birth: May 15, 1981 & last CE date 2/1/08 Example A Example B Example C Example D CE Review Dates • May 1, 2011 • May 1, 2013 Continuing Education Review Date Previous Method New Method Mrs. Smith Example C Date of Birth: Dec 14, 1968 & last CE date 1/1/08 Example A Example B Example C Example D CE Review Dates • Dec 1, 2010 • Dec 1, 2012 Continuing Education Review Date Previous Method Mr. Smith Example D Date of Birth: June 10, 1972 & NEXT CE date 6/1/10 New Method Example A Example B Example C Example D 90 Day Extension: If your CE review date is within the first 6 months of 2010, you are allowed a 90 day extension. CE Review Dates • Sept. 1, 2010 • June 1, 2012 Business Entity Licensing Jennifer Childs SueEllen Tyszkiewicz Licensing Analysts Electronic Business Entity Applications • Submitted via the NIPR gateway at www.nipr.com as of March 22, 2010 Naming of Business Entities • AG Opinion #7242: Section 213(1) of the Business Corporation Act, 1972 PA 284, MCL 450.1213(1), does not require a corporate insurance agency that includes the word "insurance" in its name to also include the word "agency," and a corporate agency is free to use the word "insurance" in its name so long as the name, taken as a whole, does not imply that the agency is an insurance or surety company. How to Prevent Delays in Application Processing Disclose ALL information Submit ALL dates of birth Make sure DRLP(s) for all lines of authority are requested on the application DRLP What is a DRLP? Designated Responsible Licensed Producer: This producer is responsible for a business entity’s compliance with state insurance laws, rules and regulations. DRLP What changes were made? Business entity applicants must designate one or more individuals as the agency’s DRLP for EACH line of authority for which the agency is applying. DRLP The 14 Day Notice If any one of the following occurs, the business entity has 14 days to solve the problem: The only DRLP of the agency loses a line of authority that the business entity holds. DRLP The 14 Day Notice If any one of the following occurs, the business entity has 14 days to solve the problem: The DRLP only DRLP becomes of theinactive agency losestoanoncompliance due line of authoritywith thatCE theany or business other reason. entity holds. DRLP The 14 Day Notice If any one of the following occurs, the business entity has 14 days to solve the problem: The DRLP becomes leaves theinactive agency. due to noncompliance with CE or any other reason. DRLP The 14 Day Notice If any one of the following occurs, the business entity has 14 days to solve the problem: The DRLP business leaves entitythenoagency. longer has a DRLP for one or more of its lines of authority. Technology Update Terri Mann Technology Specialist Interfaces with NIPR Michigan is 100% electronic in company appointments and terminations through NIPR Address Change Requests 10/28/2008 Michigan became 100% electronic for individual producers, resident and non-resident 3/22/2010 Michigan went live with electronic Business Entity applications resident and non resident Electronic applications for adjusters, solicitors and counselors Electronic License renewals Interfaces with NIPR Interfaces with NIPR Interfaces with NIPR Interfaces with NIPR Interfaces with NIPR Changing Your Mailing Address Incorrect mailing address After July 1, 2010, licensees may be fined up to…. Notify OFIR of changes within 30 days to avoid the fine. Advances in Technology Movement towards complete use of email communications. Includes: •Renewals •Pending Application Inquiries Projected Date: Dec. 2011 •CE Notices •Other insurance related correspondence Advances in Technology Enterprise Web-based Database Will be used for: •Surplus Lines Taxes •Renewals - Solicitors, Counselors, Adjusters, & Surplus Lines •CE & PE Banking for Providers Projected Date: Jan. 2011 OFIR is “going green” by utilizing online licensing notifications. Notifications will no longer be sent on paper. MORE Licensees will no longer receive the following through mail: Warning letters for C.E. C.E. Suspension letters Requests for additional information for licensure Licensure notifications Document requests What does this mean for me? You must contact OFIR with your current email address. You must add OFIR’s email address to be accepted in your mailbox. [email protected] Navigating the OFIR Website Navigating the OFIR Website Navigating the OFIR Website Afternoon Break Main Concourse Coffee Decaffeinated Coffee Cookies Entry Level Licensing Exams Paige Colley, Testing Specialist Tadas Dabsys, Vice President – PSI Services Dr. James Fryer, Senior Sales Executive – Pearson VUE Nikki Shepherd Eatchel, Vice President – Prometric Craig Johnson, Client Services Manager – Prometric Test Development Tadas Dabsys Vice President Marketing & Solution Management PSI Services LLC Regulation & Testing • Public Protection • Entry-level Knowledge • Minimum Competency • Duties & Responsibilities • State Insurance Laws & Regulations Licensing Exam Development • Validity • Reliability • Fairness • Legal Defensibility • Standards Critical Issues: Fairness • Chapter 7 in the Standards • Principle aspects of fairness: 1. Lack of bias 2. Equitable treatment 3. Equality in outcomes Critical Issues: Fairness Highlights of Chapters 8, 9 and 10 Chapter 8: Rights and Responsibilities of Test Takers - candidates’ rights Chapter 9: Testing Individuals of Diverse Linguistic Backgrounds - adaptation and potential impact on validity Chapter 10: Testing Individuals with Disabilities - ‘reasonable accommodations’ Job Analysis Survey • Job Analysis • Procedure - Content Development - Format Development Sampling Methodology • Sampling – Representative Sample • Target Groups • Sources for Addresses/Contact Information Analysis of the Survey Results • Demographic Information • Professional Activities • Knowledge - Rating and Respective Response Scales - Summary Statistics - Identification of Qualifying Professional Activities/Knowledge Content Specifications • Development of Content Specifications • Establishing Content Base for Inclusion in Exams • Linking Knowledge Areas to Professional Activities • Development of Operational Definitions • Test Outline and Content Weighting Writing Exam Questions Dr. James Fryer, Ed.D., CPCU Senior Sales Executive Business Development Pearson VUE Basic Item Writing Principals • One Correct Answer • Relevant and Appropriate • Realistic • Important to Related Task • Straightforward • Clear and Concise • No Clues that Give Away the Answer • Entry-Level Reading Level Item Writing Principals • Define the Task • Express a Complete Thought • Reduce the Reading Load • Use of Negative Words • Response Options need to: – Fits the Stem Logic – Equal in Length – Unique Meaning – Plausible – Avoid “All the Above” and “None of the Above” How? • National Subject Matter Experts – Qualifications – Experience – Background in Job Analysis Linking to Job Analysis • Activities and Tasks • Subject/Content Area of the Task • The Knowledge Statement (KSAs) Linking to Knowledge Statement Content Topic Area: Types of Life Policies Content Sub-Topic Area – Term Life Policies Job Task – Explain the special features of the policy KSA – Knowledge of the renewable and convertible features of a term life policy Linking to Knowledge Statement Knowledge Statement: The entry level practitioner must be able to explain the special features of a term life policy to a potential policyholder. Balancing Cognitive Levels Recall: Able to state the definition of “renewable and convertible.” Application: Applies knowledge of the definition of “renewable and convertible” by clearly explaining what both mean and how they can be exercised by a policyholder. Analysis: Applies knowledge of the definition by determining if the potential policyholder clearly understands the information that is being presented to him/her. Performance Analysis Nikki Shepherd Eatchel, M.A. Vice President Test Development Prometric Item Statistics p-value: Percentage of candidates in a sample who answer an item correctly. rpbis: Correlation within a sample between performance on an item and performance on the overall exam. option analysis: Percentage of candidates who answer each option. option rpbis: Correlation between performance on the options and the overall exam Forensic Data Analysis Suspicious Candidate Activity Test for significant differences in pass rates Better performance on harder items High scores in low test times Suspicious improvement in scores Candidates with unusual item timing (bimodal latencies) Previewing behavior Analysis of Subgroup Performance Tests for significant differences in pass rates Differential item functioning (DIF): DIF occurs when examinees from different subgroups with equal knowledge exhibit different probabilities of success on an item. However, DIF by itself, is not evidence of item bias. Reporting Results and Impact of Scores Candidate Score Reports Diagnostics State Reports - Monthly - Annually School Reports Topic Level Candidate Performance: MI Life Producer Exam 1665 MI Life Producer Exam 1/1/09 – 12/31/09 Number of Exams Given 4,313 Number of Total Examinees 2,808 Number of Total Examinees Passed 2,185 Percentage of Total Examinees Passed 77.8% Number of First-Time Examinees 2,664 Number of First-Time Examinees Passed 1,628 Percentage of First-Time Examinees Passed 61.1% Mean Percentage Score 69.0% Standard Deviation Percentage Score 11.2% Passing Score v. Pass Rate Passing Score: Cut Score or minimum score to pass Pass Rate: How many candidates pass the test Variables Affecting Pass Rates • Examination • Education • Candidate – Study Habits, Health • Reference Material/Study Guides • Environment • Others Vendor Presentations: Conclusion ◊ Questions ◊ Comments Thank you! Call Center Data Avg Skill Date Totals: Avg Serv Serv % Speed Calls Talk Aban Level Level Calls Answered Answered Time (Sec) Calls % Calls Answered 48 14,800 379 421 83.2% 12,311 97.2% MIINS January-09 63 1,125 488 35 81.1% 912 97.0% MIINS February-09 37 1,176 349 32 86.1% 1,013 97.4% MIINS April-09 62 494 364 21 76.5% 378 95.9% MIINS May-09 54 1,626 366 51 80.3% 1,306 97.0% MIINS June-09 58 1,674 380 80 78.2% 1,309 95.3% MIINS July-09 38 1,696 351 32 86.5% 1,467 97.9% MIINS August-09 56 1,449 383 56 82.2% 1,191 95.5% MIINS September-09 42 1,412 365 52 83.9% 1,184 95.8% MIINS October-09 45 1,423 379 50 83.4% 1,186 95.7% MIINS November-09 45 1,370 360 50 83.0% 1,137 96.0% MIINS December-09 26 1,355 380 29 90.6% 1,228 97.3% Recruitment of SME’s for ERW August 19, 2010 Craig Johnson, MPA Client Services Manager Financial Services Prometric ERW OVERVIEW Prometric and the Michigan Office of Financial and Insurance Regulation conducted the annual exam review workshop to: • Review content outlines for applicability with current Michigan statutes, rules, regulations and Insurance Department policy; • Review test items – questions and responses – for clarity and relevance; • Draw on the expertise of local insurance professionals to further validate the test content used in the state. • Prometric performs an exam review for all exams in Michigan every two years to cover National and State content OVERVIEW OF EXAM REVIEW WORKSHOP • The Michigan Office of Financial and Insurance Regulation and Prometric identified and enlisted approximately 38 Michigan industry professionals to participate in the 2009 workshop. • Participants represented various industry affiliations, levels of experience, and geography • This breadth of representation was sought to ensure development of exam content that tests entry-level knowledge for licensing in Michigan . Each test item was either accepted, modified, or removed from the item bank after it was reviewed. ERW TIMELINE OF ACTIVITIES The ERW is one of the first of several steps in the process to update test content and to republish Michigan Insurance exams in Prometric test center network. Course Exam Test Outline Review Design Revisions Workshop Revisions Test Test Publishing Quality Exam Distribution The target date for next Michigan Insurance ERW is August 19, 2010 *New exam outlines available post ERW Exam Review Workshop- Content Review Both National and Michigan - Specific Content Reviewed • Reviewed annually by Committees Committee is chosen and invited by OFIR Industry Leaders and OFIR employees are represented Every line is thoroughly reviewed by participants ERW participants are not responsible for item writing but review and re-write to ensure it meets OFIR standards; however, OFIR conducted item writing session in the past EXAM CONTENT OUTLINE Licensing Examination Bulletin http://www.prometric.com/Michigan/Insurance.htm Click the download button under the heading “Find Answers to Your Questions” Outlines http://www.prometric.com/Michigan/content-outlines.htm Problem Applications Tracey Peck Licensing Specialist Inaccurate Application Responses Errors in CRIMINAL and ADMINISTRATIVE background questions are the most common among application responses. EXCEPTIONS: CRIMINAL Misdemeanor traffic offenses andmilitary juvenile Misdemeanors, felonies and offenses. acts (offense Convictions delinquent Judgment deferredfor which you were must be convicted as a juvenile). reported, including: Pending charges **NOTE** Guilty convictions If you doOffense not disclose conviction your was where aafine / probation on / suspension given application and one is found during our check, the failure tonolo disclose is a reason Guilty plea or contendre to deny you a license! Inaccurate Application Responses Errors in CRIMINAL and ADMINISTRATIVE background questions are the most common among application responses. EXCEPTIONS: Misdemeanor traffic offenses and juvenile delinquent acts (offense for which you were convicted as a juvenile). **NOTE** If you do not disclose a conviction on your application and one is found during our check, the failure to disclose is a reason to deny you a license! Inaccurate Application Responses Errors in CRIMINAL and ADMINISTRATIVE background questions are the most common among application responses. ADMINISTRATIVE Having a license censured / suspended / cancelled / EXCEPTIONS: terminated Only exceptions are terminations due solely Admin. action Being assessed to noncompliance witha fine continuing education must be orReceiving failure toa cease pay aand renewal fee. desist order reported, Receiving a compliance or prohibition order including: Surrendering a license to resolve an admin. action Being party to an admin. action or arbitration hearing Questions & Answers OFIR Licensing Staff Adjournment Please complete an evaluation. Thank you for attending the 2010 Best Practices Forum!